Nearsightedness: What is Myopia

Myopia, commonly known as nearsightedness, is a refractive error of the eye that affects a person's ability to see distant objects clearly. Individuals with myopia can see nearby things clearly, but objects in the distance appear blurry or out of focus. This condition occurs when the eyeball is slightly elongated or the eye's curvature is too round, causing light to focus in front of the retina instead of directly on it.

Myopia is a common vision problem, and its prevalence has increased globally. It's estimated that by 2050, half of the world's population will be nearsighted. It can develop during childhood or adolescence and continue progressing until early adulthood. Genetics and environmental factors, such as excessive near-work or limited outdoor time, are believed to play a role in myopia development. Regular eye exams with an optometrist or ophthalmologist are essential for early detection and management of myopia. 

People with myopia often rely on corrective measures such as eyeglasses or contact lenses to help them see clearly. In some cases, refractive surgeries like LASIK, PRK, or SMILE can also be considered to reduce or eliminate the need for glasses or contacts. 

Nearsightedness: Myopia Types

There are different types of myopia, which can be categorized based on various factors. However, here are the two most common types:

1. Simple Myopia: Simple myopia, also known as axial myopia, is the most common type of myopia. It occurs when the eyeball is elongated, causing light to focus in front of the retina. Simple myopia is typically corrected with eyeglasses, contact lenses, or refractive surgeries.

2. Pathological Myopia: Pathological myopia, also called degenerative or high myopia, is a more severe form of myopia. It is characterized by a significant eyeball elongation, leading to progressively worsening nearsightedness. Degenerative myopia is associated with a higher risk of complications such as retinal detachment, glaucoma, cataracts or myopic maculopathy. 

Nearsightedness: Myopia Symptoms

The most common symptoms of myopia, or nearsightedness, include:

1. Blurred Vision: Distant objects appear blurry or out of focus, while nearby things may still be clear.

2. Squinting: Squinting is a natural instinct to try and improve focus by narrowing the opening through which light enters the eyes, temporarily sharpening vision.

3. Eye Strain: Myopia can cause eye strain, particularly when trying to see objects at a distance for an extended period. This can lead to discomfort, headaches, or fatigue.

4. Difficulty Seeing Objects in the Distance: Nearsighted individuals may have trouble seeing road signs, a whiteboard in a classroom, or the faces of people in the distance.

5. Holding Objects Closer: Those with myopia may instinctively hold books, smartphones, or objects closer to their face to see them more clearly.

6. Blinking to See Clearly: In an effort to improve focus, individuals with myopia may frequently blink to try and bring objects into better clarity.

7. Eye Fatigue during Visual Tasks: Extended periods of reading, writing, or screen use can lead to eye fatigue, strain, or discomfort. 

It's important to note that these symptoms can vary in severity depending on the degree of myopia. If you or someone you know experiences these symptoms or has concerns about their vision, seeing an optometrist for a comprehensive eye examination is essential. 

Nearsightedness: Myopia Causes

The exact cause of myopia is not fully understood. Still, it is believed to be a combination of genetic and environmental factors. Here are some factors that may contribute to the development of myopia:

1. Genetics: Myopia tends to run in families, suggesting a genetic component. If one or both parents have myopia, there is an increased likelihood of their children developing myopia as well. 

2. Environmental Factors: Certain environmental factors have been associated with an increased risk of myopia. These include:

• Near Work: Engaging in activities that require prolonged focusing on close-up objects, such as reading, writing, or using digital devices, has been linked to myopia development. However, the specific relationship between near work and myopia is still being studied.

• Lack of Outdoor Time: Spending less time outdoors, especially during childhood and adolescence, has been associated with a higher risk of myopia. Exposure to natural light and outdoor environments may have a protective effect against nearsightedness. It is recommended that all children spend at least 2 hours a day outside. 

• Visual Stress: Intense or prolonged visual tasks that strain the eyes, such as extended reading or screen use, may contribute to myopia development. Children should limit the amount of time they spend on devices like cell phones. 

3. Refractive Changes during Eye Growth: The eye undergoes normal changes in shape and size during childhood and adolescence. In myopia, the eyeball tends to become elongated, causing light to focus in front of the retina instead of directly on it. 

Regular eye exams with an optometrist are crucial for early myopia detection, diagnosis, and management. Early intervention and appropriate vision correction can help minimize the impact of myopia and optimize visual outcomes. In addition, your optometrist may be able to prescribe specific treatments that can slow the rate of progression. 

Nearsightedness: What Are the Long-Term Risks of Myopia?

Long-term risks associated with myopia, axial or pathological myopia, include:

1. Increased Risk of Eye Conditions: High myopia is associated with an elevated risk of developing various eye conditions, including:

2. Retinal Detachment: The elongation of the eyeball in high myopia can increase the risk of retinal detachment. This occurs when the retina, the thin layer of tissue at the back of the eye, detaches from its normal position, leading to vision loss and potential blindness if not treated promptly.

3. Myopic Maculopathy: Myopic maculopathy refers to damage or degeneration of the macula, the central part of the retina responsible for detailed vision. High myopia's stretched and thinning retina can lead to macular changes, potentially resulting in vision loss and distortion. 

4. Glaucoma: Myopia has been associated with a higher risk of developing open-angle glaucoma, a condition characterized by damage to the optic nerve and progressive vision loss.

5. Cataracts: Although the relationship is not fully understood, some studies suggest that myopia, particularly high myopia, may be associated with an increased risk of both nuclear and posterior subscapular cataracts, a clouding of the eye's natural lens.

6. Reduced Quality of Life: Severe myopia can significantly impact an individual's quality of life. The reliance on corrective lenses, limitations in participating in certain activities, and the potential for visual complications can affect daily functioning, mobility, and overall well-being.

7. Visual Impairment and Legal Blindness: In cases of extremely high myopia, individuals may experience significant visual impairment. In rare instances, high myopia can lead to legal blindness, which refers to having a central visual acuity of 20/200 or worse in the better eye, even with correction.

It's important to note that while myopia carries these risks, not all individuals with myopia will develop severe complications. The progression and severity of myopia can vary from person to person. 

Nearsightedness: Myopia Diagnosis

Optometrists diagnose myopia through a comprehensive eye examination that typically includes the following steps:

1. Case History: The optometrist will begin by asking about your medical history, including any previous vision problems, family history of myopia, and any symptoms or concerns you may have regarding your vision.

2. Visual Acuity Test: This test measures how well you can see at various distances. You will be asked to read letters or symbols on a chart (Snellen chart) from a standardized distance. The optometrist will determine your visual acuity and assess if you have difficulty seeing distant objects clearly, a common sign of myopia.

3. Refraction Test: During a refraction test, the optometrist uses an auto-refractor, phoropter and various handheld devices to determine the exact prescription needed to correct your vision. You will be asked to look through a series of lenses and provide feedback on which ones help you see more clearly. This process allows the optometrist to measure the degree of myopia and determine the appropriate corrective lens prescription.

4. Retinal Examination: The optometrist will examine the health of your eyes, including the retina, using various instruments. This may involve dilating your pupils using eye drops to allow for a better view of the back of your eye. The optometrist will check for any signs of abnormalities or conditions associated with myopia, such as retinal thinning or degeneration. The optometrist may also recheck your refraction during the dilation, as the drops used to enlarge your pupils will also temporarily relax your eye muscles. 

5. Additional Tests: Depending on your specific situation and any other symptoms, the optometrist may perform further tests to assess your eye health and the extent of your myopia. These tests may include visual field testing, corneal topography, or imaging tests like 3D optical coherence tomography (OCT) or optomap ultra-widefield imaging to evaluate the structures of your eyes in more detail.

Nearsightedness: Myopia Treatment

There are several treatment options available for managing myopia, including:

1. Prescription Eyeglasses: Eyeglasses with lenses that have a negative (concave) power are the most common and straightforward way to correct myopia. They help focus light properly onto the retina, improving distance vision.

2. Contact Lenses: Contact lenses are an alternative to eyeglasses and provide a clear field of vision. They come in various types and modalities, including soft and rigid gas-permeable (RGP) lenses. 

3. Multifocal Eyeglasses or Contact Lenses: These lenses have different optical powers in different areas of the lens, allowing for clear vision at various distances. They can simultaneously correct both myopia and presbyopia (age-related near-vision loss).

4. Orthokeratology (Ortho-K): Ortho-K involves wearing specially designed rigid-gas-permeable (RGP) contact lenses overnight. These lenses temporarily reshape the cornea, providing clear vision during the day without needing corrective lenses. However, the effects are temporary, and the lenses must be worn regularly to maintain the corneal reshaping.

5. Atropine Eye Drops: Low-dose atropine eye drops can be prescribed to slow down the progression of myopia, particularly in children. These drops help relax the eyes' focusing mechanism, thereby reducing the eyeball elongation associated with myopia progression. Low-Dose atropine eye drops may also play a role in regulating the growth receptor of the eye. However, this relationship is still not well understood. 

6. Myopia Control Soft Contact Lenses: Certain soft contact lenses are specifically designed for myopia control. Contact lenses like MiSight by CooperVision use various optical techniques to slow down the progression of myopia in children, such as peripheral defocus, which can help alter the growth of the eye.

7. Refractive Surgeries: Surgical procedures like LASIK (Laser-Assisted in Situ Keratomileusis), PRK (Photorefractive Keratectomy), and SMILE (Small Incision Lenticule Extraction) can permanently reshape the cornea to correct myopia. These procedures are typically recommended for individuals with stable myopia and meet specific criteria.

Nearsightedness: Myopia Prevention

While myopia cannot be entirely prevented, certain strategies may help reduce the risk or slow down the progression of myopia in children. Here are some tips:

1. Outdoor Time: Encourage your children to spend more time outdoors, engaging in activities that require distance vision. Research suggests that increased outdoor time, especially during early childhood, reduces the risk of developing myopia or slower progression. At Helio Optometry, we recommend that all children spend at least 2 hours per day outdoors. Your kids can still wear a hat or sunglasses for protection from UV rays.

2. Reduce Near Work and Screen Time: Prolonged engagement in activities that involve close-up focusing, such as reading, using electronic devices, or doing near work for extended periods, may contribute to myopia development. Encourage regular breaks and the 20-20-20 rule: Every 20 minutes, look at something 20 feet away for at least 20 seconds.

3. Proper Lighting and Ergonomics: Ensure that the environment where your children perform close-up tasks is well-lit and the viewing distance and angles are appropriate to avoid excessive eye strain.

4. Maintain a Healthy Distance: Encourage your children to maintain a proper working distance while reading or using electronic devices. It is recommended to hold books or screens at least 14 to 16 inches away from the eyes. The 'Harmon Distance' is considered to be the optimal visual distance for reading and other close work. It is measured by placing a closed fist under the chin and then holding a book at the tip of the elbow. The book should not come any closer.

5. Consider Myopia Control Options: Talk to one of our optometrists about myopia control options, such as myopia contact lenses, orthokeratology (Ortho-K) lenses, low-dose atropine eye drops or special myopia eyeglass lenses. These methods may help slow myopia progression in children at higher risk or rapidly progressing myopia.

6. Regular Eye Exams: Schedule routine eye examinations for your children with an optometrist. Early detection and management of myopia are essential for monitoring its progression and implementing appropriate interventions.

It's important to note that while these strategies may help reduce the risk or slow down myopia progression, they do not guarantee complete prevention. Each child's risk and response to these measures can vary.

Nearsighted (Myopia) Eye Care in Edmonton

Helio Optometry can help people of all ages achieve better vision. We diagnose and treat various eye conditions, then get you the glasses or contacts they need so they have clear, comfortable vision in work, life and play. Contact us at 780-628-6855 to book an appointment at our new eye care clinic located in West Edmonton on 149th Street and 95th Ave. We anchor the communities of Crestwood, Parkview, Sherwood and Jasper Gats.